ArticleAACE clinical case reports
ELETRIPTAN (RELPAXA™) CAUSING FALSE POSITIVE ELEVATIONS IN URINARY METANEPHRINES.
Article in AACE clinical case reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed, 0 citations in OpenAlex.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePheochromocytoma is diagnosed biochemically by demonstrating an excessive production of catecholamines and their metabolites in the blood and urine. However, these tests are at times fraught with false-positive results due to drug effects. We report here a patient with markedly elevated urinary metanephrines associated with the use of eletriptan for migraine treatment.
methodsA literature search was conducted using the PubMed and Google Scholar databases for eletriptan and false positive metanephrine elevation. Urine and plasma metanephrine tests were performed via liquid chromatography/tandem mass-spectrometry.
resultsA 29-year-old man with migraine recently started on eletriptan was evaluated for a worsening headache. Initially his blood pressure was 220/160 mm Hg with a creatinine of 1.9 mg/dL. He was treated with intravenous nicardipine. His lab tests showed normal aldosterone/plasma renin activity ratio, midnight salivary cortisol, thyroid function, and urinary drug screen. A 24-hour urine metanephrine level at 2,494 μg (normal, 45 to 290 μg) and normetanephrine level at 1,341 μg (normal, 82 to 500 μg) for secondary hypertension work-up were markedly elevated. In contrast, plasma metanephrines were at 27 pg/mL (normal, 0 to 62 pg/mL) and normetanephrines were at 255 pg/mL (normal, 0 to 145 pg/mL) were only mildly elevated. Adrenal CT and gallium-68 positron emission tomography/computed tomography showed no abnormalities. Within 1 week of eletriptan discontinuation, his urine and plasma metanephrine and normetanephrine levels completely normalized as well as a reduction of blood pressure (130's/80's mm Hg).
conclusionThe discrepancy between plasma and urine studies in our patient suggests the possibility of false positive tests. It is possible that eletriptan may affect the urine assays, but the exact mechanism causing elevated urine metanephrines/normetanephrines is not clear.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.